Structural Heart Disease

Structural heart diseases include any issues preventing normal cardiovascular function due to damage or alteration to the anatomical components of the heart. This is caused by aging, advanced atherosclerosis, calcification, tissue degeneration, congenital heart defects and heart failure. The most commonly treated areas are the heart valves, in particular the mitral and aortic valves. These can be replaced through open heart surgery or using cath lab-based transcatheter valves or repairs to eliminate regurgitation due to faulty valve leaflets. This includes transcatheter aortic valve replacement (TAVR). Other common procedures include left atrial appendage (LAA) occlusion and closing congenital holes in the heart, such as PFO and ASD. A growing area includes transcatheter mitral repair or replacement and transcatheter tricuspid valve repair and replacement.

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The Pascal transcatheter mitral valve repair system. Similar to the latest version of the MitraClip, the Pascal can operate each leaflet independently to grasp the mitral valve leaflets. Results of the CLASP IID trial at #TCT2022.

Pascal transcatheter mitral repair device performs as well as MitraClip in late-breaking CLASP IID Trial 

Comparison between transcatheter edge-to-edge repair (TEER) devices found Pascal was non-inferior compared with MitraClip in the CLASP IID pivotal trial.

Sentinel Boston Scientific PROTECTED TAVR stroke disabling stroke

TAVR embolic protection devices fail to reduce stroke risk, but some cardiologists—and a leading vendor—remain encouraged

The PROTECTED TAVR results presented at TCT 2022 resulted in a mix of reactions. For some cardiologists, the slight reduction in the risk of a disabling stroke after TAVR is a positive result. For others, it was simply not enough. 

he U.S. Food and Drug Administration (FDA) granted market clearance ion September 2022 for the Edwards Lifesciences Corp. Pascal Precision transcatheter valve repair system for transcatheter edge-to-edge repair (TEER). It is indicated for the treatment of patients with degenerative mitral regurgitation (DMR).

FDA clears Edwards Pascal device for transcatheter mitral valve repair

This is the second FDA-cleared transcatheter repair device for the mitral valve. Data from pivotal trial comparing Pascal vs. MitraClip will be presented at TCT 2022.

Examples of structural heart transcatheter valve replacement procedure planning CT scans and post procedure followup for TMVR and TAVR.

VIDEO: CT imaging for TAVR and TMVR structural heart interventions

Joao Cavalcante, MD, director, cardiac MRI and structural CT labs, Minneapolis Heart Institute, discusses the use of cardiac CT imaging to plan and guide structural heart procedures. 

A structural heart Presentation during the TVT 2022 conference. #TCT #TCT22 #TCT2022

TCT 2022 late-breaking clinical presentations announced

The Cardiovascular Research Foundation (CRF) announced the 32 late-breaking studies being presented at the Transcatheter Cardiovascular Therapeutics 2022 annual meeting at in Boston, Sept. 16-19.

Cardiac surgeons perform the world’s first partial heart transplant

“This procedure potentially solves the problem of a growing valve,” the lead surgeon said. “If we can eliminate the need for multiple open-heart surgeries every time a child outgrows an old valve, we could be extending the life of that child by potentially decades or more.”

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HFpEF patients with MR may face a higher mortality risk—but not if they have AFib

There is an established connection between MR and HFrEF, but we know much less about the link between MR and HFpEF. 

Three transcatheter tricuspid valve repair and replacement (TTVR) technologies that will likely see FDA clearance in. the next couple years include the Edwards Evoque transcatheter tricuspid valve (top left), Abbott TriClip (below) and the Edwards Lifesciences Pascal clip device (right).

Tricuspid valve therapies moving ahead of mitral therapies seeking market approval

The complexity of the mitral valve has slowed development of new transcatheter technologies, and it now seems much more likely that transcatheter devices for tricuspid valve will push ahead to gain FDA clearances.

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